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Inevitable?
Jul 22, 2006

How many patients do you, and colleagues you confer with often, have who are long-term non-progressors? Im very irritated to have gone for 21 years, and still having good percentages and VL <50, to now be having dwindling CD4s. Dr.'s explanation was something along the lines of even without a raging viral load, the virus' very presence is wearing upon you, and thus declining CD4s were inevitable. In fact, he alluded to the notion that my being treated should have been presumed to be inevitable, even after 20 years; thus that "everyone will have AIDS eventually" sans treatment. Without being nave, I would like to think that we don't really know what every long-term non-progressor may or may not do, and like you said in another answer, everyone's biology is different. But he seems to think it's a faît accompli. What are your thoughts on the future of current non-progressors? (Assuming there are enough out there to comment about!).

Response from Dr. Holodniy

I agree with your perspective. However, since the history of the epidemic is still unfolding, we don't know what the ultimate natural history of long term survivors or "nonprogressors" is going to be. We need to see enough people with infection for 20 years or longer and who have not received any treatment and follow them for another 10-30 years of normal life span to see the end result.



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